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856Type of Legislation: General Bill GBIntroducing Body: SenateIntroduced Date: 19990525Primary Sponsor: McConnellAll Sponsors: McConnell, MescherDrafted Document Number: l:\council\bills\nbd\11412jm99.docResiding Body: SenateCurrent Committee: Banking and Insurance Committee 02 SBISubject: Health maintenance organization, enrollee, civil actions for damages when services not paid but covered, InsuranceHistory Body Date Action Description Com Leg Involved ______ ________ ______________________________________ _______ ____________ Senate 20000601 Co-Sponsor added by Senator Mescher Senate 19990525 Introduced, read first time, 02 SBI referred to Committee Versions of This Bill
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 38-33-85 SO AS TO ENDOW AN ENROLLEE OF A HEALTH MAINTENANCE ORGANIZATION WITH THE RIGHT TO INSTITUTE AND MAINTAIN A CIVIL ACTION FOR DAMAGES, OR AN ACTION FOR DECLARATORY AND INJUNCTIVE RELIEF, OR BOTH SUCH ACTIONS, AGAINST HIS HEALTH MAINTENANCE ORGANIZATION FOR THE LATTER'S DENIAL OF, OR REFUSAL TO ALLOW, TREATMENT OR PAYMENT, OR BOTH, WITH RESPECT TO SERVICES OR COVERAGE INCLUDED IN THE EVIDENCE OF COVERAGE.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. The 1976 Code is amended by adding:
"Section 38-33-85. Notwithstanding any other provision of law, an enrollee of a health maintenance organization subject to the provisions of this chapter shall be allowed to institute and maintain a civil action for damages, or an action for declaratory and injunctive relief, or both such actions, in a court of competent jurisdiction of this State against his health maintenance organization for the latter's denial of, or refusal to allow, treatment or payment, or both, with respect to services or coverage included in the evidence of coverage, as the latter term is defined in Section 38-33-20(5). Any provision to the contrary contained in the evidence of coverage shall be deemed null and void and of no effect whatever."
SECTION 2. This act takes effect upon approval by the Governor.
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